Monthly Archives: December 2015

The Association of American Medical Colleges (AAMC) reported in March of 2015, that by the year 2025, demand for physicians will exceed the supply by a projected shortfall of 46,100 to 90,400. Although significant, these numbers are much smaller than numbers previously projected in a 2010 study. That study reported demand to exceed supply by 130,600. One of the factors supporting the difference between the 2015 and 2010 projections is the rise in the number of physicians completing their graduate medical education from 27,000 to approximately 29,000 annually.

To read the full Final Report addressing The Complexities of Physician Supply and Demand: Projections from 2013 to 2025 submitted by IHS Inc. for AAMC, click here.

With this being the case, the new number of medical school enrollees for 2015, should shed some hope over these dismal projections. According to data released by AAMC in October 2015, the number of students enrolling in medical schools across the nation has increased by a whopping 25 percent since 2002, reaching an all-time high of 20,630 this year. Locally, the University of Central Florida (UCF) College of Medicine received 4,875 applicants this year. That is an increase from last year by about 700 applicants. Overall, the number of medical school applicants rose by more than 6 percent in 2015, which doubles the percentage of 2014.

Increased Efforts to Diversify.

President and CEO of the AAMC, Darrell G. Kirch MD, stated, “The nation’s medical schools are creating innovative education and training programs to prepare tomorrow’s doctors to meet the challenges of the changing health care environment. This dynamic landscape is leading to a record number of students applying to and enrolling in medical school.”

Dr. Kirch is hopeful that the consistent increases in the number of applicants and the broadened diversity of students enrolling in medical school will continue. Dr. Kirch encourages medical schools to sustain efforts in their communities to diversify the applicant pool through pipeline programs, outreach efforts and holistic review initiatives.

The year 2015 brought increases in nearly every racial and ethnic category as medical school classes continued to diversify. Most significantly, African American enrollees rose by 11.6 percent from last year, with the number of applicants increasing by an impressive 16.8 percent. The number of Hispanic or Latino applicants was not far behind with a marked 10.3 percent increase from last year. This category saw an increase in enrollees as well. And while the percentage of male enrollees versus female enrollees remained consistent with last year’s numbers, first-time applicants saw a 6.2 percent increase among women.

To read more about the overall increases in applicants and enrollees, click here.

Physician Shortage May Still Persist.

In a statement released in March 2015, Dr. Kirch said, “The doctor shortage is real–it’s significant–and it’s particularly serious for the kind of medical care that our aging population is going to need.” Dr. Kirch relied upon the study conducted by the Life Science division of IHS Inc. for AAMC in support of his statement. The study shows that physician demand over the next decade is projected to grow faster than supply by up to 17 percent. Furthermore, the forecast is believed to persist under every likely scenario including:

(a) increased use of advanced practice nurses (APRNs);

(b) greater use of alternative settings such as retail clinics;

(c) delayed physician retirement;

(d) rapid changes in payment and delivery; and

(e) other modeled scenarios.

Dr. Kirch contends, “Because training a doctor takes between five and [ten] years, we must act now, in 2015, if we are going to avoid serious physician shortages in 2025.” Dr. Kirch believes that the solution for the higher-end physician shortage projections will require a multi-pronged approach. This approach includes:

(a) innovation in delivery;

(b) greater use of technology;

(c) improved, efficient use of all health professionals on the care team; and

(d) an increase in federal support for residency training with the goal being to train at least 3,000 more doctors each year.

The study confirmed that no single solution is sufficient on its own in providing a resolution to the physician shortages. It must be a collaboration of efforts. And according to Dr. Kirch and judging by this year’s numbers, it would seem medical schools are most certainly doing their part to prepare the next generation of health care professionals able to take on the growing health care needs of our aging population.

To read more about the key findings on the physician supply and demand through 2025, click here.

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and any other matters.

About the Author: Ritisha K. Chhaganlal, J.D., is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone (407) 331-6620.

University of Central Florida (UCF) second-year medical student, Christa Zino, and her 2-year-old adopted canine friend, Ion (a boxer), know that smiles can go a long way in healing the spirits of hospital-bound children during the holidays. And they don’t stop there. Zino and Ion visit Nemours Children’s Hospital (Nemours) in Orlando most Friday evenings to bring some joy to children who often have to endure extended hospital stays, arduous medical tests and procedures, and separation from family, home and school. Most of these young children lack a normal childhood experience due to their illnesses, but Zino knows that Ion has what it takes to keep these tenacious little ones going strong regardless of their current circumstance.

That’s why even a busy schedule and final exams cannot keep Zino and Ion away from Nemours this month. UCF Today quoted Zino as stating, “When I think it is too much and that I can’t handle everything, this reminds me…why I want to be a pediatric surgeon. I want to help children like the ones I see every week.”

Ion is one of Zino’s three canine companions chosen by Zino to become officially certified for pet therapy. Ion was adopted by Zino from Florida Boxer Rescue. Zino says Ion is reserved around children and “gentle in a way he never is when he’s just with me [Zino].” The fact that Ion is all-around a big fur ball of friendly should not be surprising considering his beginning (prior to rescue). Apparently Ion has always lacked aggression, which most dog owners would appreciate, but ironically landed Ion on Craigslist by a disgruntled former owner who was disappointed that Ion was not a “fighting champion.”

Good riddance, however, because it seems Ion has found his perfect fit with Zino as a “health care professional,” providing therapy to others in the form of palm kisses and snuggles. And he’s quite the hit within the UCF campus community of medical students as well, providing Zino’s fellow stressed-out and sleep-deprived classmates with a welcomed “pick-me-up” three times a week.

Zino’s Inspiration to Assist Children: Drawing From Her Own Experience.

Zino knows firsthand how dismal hospital life can be for a child because she was an extended-stay patient as a child herself. Zino was diagnosed with a bile-duct blockage as a toddler. With her condition being so rare in someone so young, Zino spent 18 months in and out of hospitals and away from her home and Chihuahua in Apopka, Florida.

While Zino recalls very little from her experience, the one thing she vividly remembers is her visit from a furry friend. As reported by the Orlando Sentinel, Zino says she simply remembers “being happy” as a therapy dog sat on her bed keeping her company during a difficult time.

It was this very experience and positive memory that has led Zino to pursue a career as a pediatric surgeon as well as to carry on the grand tradition of meet-and-greets between sick children and a furry friend who shows up just in time to make them smile.

Are you currently a medical student, or are you considering a career in medicine?

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and any other matters.

About the Author: Ritisha K. Chhaganlal, J.D., is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone (407) 331-6620.

By Ritisha K. Chhaganlal, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Christmas is flooding the department stores and malls with candy canes and toys, holly and trees, and bells and carols. It’s the most wonderful time of the year…right? Perhaps for some. But according to University of Central Florida (UCF) police Cpl. Peter Osterrieder, a rise in Baker Acts (involuntary confinement for mental health issues) is to be expected among college students around the winter holidays.

Not only do UCF police expect to see more Baker Acts during this “feel-good” time of year, but as reported by statistics within the police department, Baker Acts among college students are on the rise overall. Just this year, UCF police have committed 94 individuals, mostly college students. That’s triple the number of cases from 2010, and up from 76 cases just last year. UCF police Chief Richard Beary said several factors are likely to have contributed to the annual rise.

What Does it Mean to be “Baker Acted”?

Baker Acts are necessary when a person is mentally unstable and considered a danger to themselves or someone else. Individuals who are Baker Acted can be held for up to three days against their will for an emergency medical evaluation. To be held beyond the 72-hour period, which often happens, the psychiatric treatment facility requires either the voluntary consent of the individual or court intervention. For more information and statistics on Baker Acts, please view the Florida’s Baker Act: 2013 Fact Sheet by the Department of Children and Families (DCF) here.

In our experience representing individuals who have been wrongfully confined, however, we find the law if often violated.

Factors Contributing to Baker Acts Among College Students.

Osterrieder said the stress brought on by semester finals can push students to their breaking point. This is especially true for college freshman spending their first semester away from home, family and friends. Osterrieder commented to reporters for the Orlando Sentinel, “They [college students] don’t have mom and dad to lean on every day, the best friends they’ve had their entire life growing up. That challenge is very difficult for them.” All things considered, college life can become quite overwhelming.

Beary noted the growing student body at UCF as a contributing factor as well. With 63,000 students currently enrolled, UCF is among one of the largest universities in the nation. Beary also acknowledged the increase in public awareness of mental health conditions which results in more calls for help from those suffering, their loved ones or others observing concerning behaviors.

Baker Acts: Naughty or Nice?

While the intention of the involuntary confinement of individuals requiring emergency mental health assistance is pure, erroneous confinement can actually exacerbate the underlying medical or mental health condition for some. Still for others, the existence of a mental health condition is purely speculative and therefore treatment is unnecessary and even harmful.

Knowing your rights as a patient or as the parent of a student under a Baker Act restraint is essential in such cases. Consulting with an experienced health attorney can better guarantee adequate help for you or your loved one.

For more information on a similar law in the state of Florida for involuntary confinement for individuals with substance abuse problems (called the Marchman Act), click here.

Comments?

Do you have a student who is being involuntarily confined under the Baker Acted? Do you believe their confinement is erroneous or they are not being adequately treated for their mental health condition?

Contact Health Law Attorneys Experienced in Handling Victims of Involuntary Confinement Through the Baker Act and Marchman Act.

The Health Law Firm represents individuals, families and friends in challenges to and hearings related to the Florida Baker Act and Marchman Act, when the basic criteria for confinement are not met and there is no medical necessity for further confinement.

Our firm has a process we follow to make sure that a person who should not be held under the Baker Act may be released in a very short time. If the basic criteria for a Baker Act confinement are not present, the person is not required to be held and should be released. If the person has been living independently for decades, has family and a support system available, and has had no prior mental health problems, the odds are he or she should not be involuntarily confined. We act immediately to begin our representation, to make the hospital and its physicians aware that we are representing you, and to take measures to obtain release. If required, we are prepared to file an emergency Petition for Writ of Habeas Corpus with the local Circuit Court to have you brought before the judge for an emergency release hearing. These cases can be time intensive, require a great deal of immediate work, but can yield fast results in most cases.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

By Ritisha K. Chhaganlal, J.D.
According to a study done by the Association of American Medical Colleges (AAMC), the number of students enrolling in medical schools has reached an all-time high.

In 2014, the total number of applicants rose by 3.1 percent. AAMC President, Darrel G. Kirch M.D., expressed concerns regarding the availability of residency training positions for aspiring doctors. Dr. Kirch stated: “As we face a worsening shortage of both primary and speciality physicians over the next two decades, Congress must increase federal support for residency training by lifting the 17-year-old cap on residency training positions imposed under the Balanced Budget Act.” To read the AAMC’s press release in its entirety, click here.

It is unsurprising that medical students across the nation are concerned about securing a residency position after graduation. However, an analysis conducted by The New England Journal of Medicine (NEJM) suggests that this General Medical Education (GME) “squeeze” is actually not as severe as many believe.

History Behind Medicare Resident Limit Caps.

The Balanced Budget Act of 1997 (BBA) was established to cap the number of residents and fellows for the purposes of calculating Medicare reimbursements against each hospital’s most recent cost report. There are a few exceptions; the BBA cap on the number of residents does not apply to new programs in underserved rural areas for three years. After three years, these programs are considered to have enough time to fill their residency cohorts.

The Medicare program is the largest source of funding for GME. Given this limit of funding, many believe that it will also limit the number of residents and fellows.

Analysis Indicates Growth in Entry-Level GME Positions.

The NEJM studied data from the Accreditation Council for Graduate Medical Education (ACGME), AAMC, and the American Association of Colleges of Osteopathic Medicine (AACOM), for the time periods of 2004-2005 and 2013-2014. The NEJM found that entry-level GME positions increased from roughly 25,000 in 2004-2005, to about 29,000 in 2013-2014. This is a total increase of approximately 4,000 positions. Additionally, the number of U.S. graduates with M.D. and D.O. degrees grew from about 19,000 in 2004-2005, to roughly 23,000 in 2013-2014. This is an increase of approximately 4,000 graduates.

If the number of GME positions increases as it has been over the past decade, it is projected that there will be approximately 34,000 positions for medical graduates entering their first year of residency in 2023-2024. The number of medical students is expected to increase due to newly opened M.D. and D.O. schools. As a result, it is assumed by AAMC that a 2.4% annual growth of medical graduates will continue onto 2023-2024.

In 2023-2024, the number of graduates projected will be marginally more than 29,500. With these numbers, there will be approximately 4,500 more open positions for residency than U.S. medical graduates in 2023-2024. While the number of positions available to graduates compared to 2013-2014 is less, the amount of GME positions will still significantly exceed the amount of U.S. medical graduates.

What Does this Mean for Medical Graduates?

Although the amount of GME positions will exceed the amount of medical graduates, the gap is still narrowing over the years. Over the past 50 years, medical graduates benefitted from “selection subsidy,” which allowed them to start residency at the location and in the speciality of their own choosing. However, the likelihood of a medical graduate finding the exact location and speciality he or she desires may not be an option anymore. Despite this, the most intense competition for these residency positions lies amongst the International Medical Graduates (IMGs). Although U.S. graduates will be affected by this slight “squeeze,” IMGs face an overall tougher road. To read one of our previous blogs focusing on future physicians, click here.

Comments?

Do you think there is not enough residency positions to meet the influx of medical graduates? Do you think Congress should fund more GME positions in order to create a larger margin for U.S. graduates?

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such indiviuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and any other matters.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Vernon, Jamila. “More Students Going to Medical School Than Ever Before.” AAMC. October 29, 2015. Web.

“Why a GME Squeeze in UNlikely.” NEJM. November 4, 2015. Web.

“Medicare Resident Limits.” AAMC. Web.

“US Residency Training Before and After the 1997 Balanced Budget Act.” JAMA. September 10, 2008. Web.

About the Author: Ritisha K. Chhaganlal, J.D., is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone (407) 331-6620.